Last weekend 11 friends, 3 dogs and I hiked for 3 days between Malealea and Semonkong. I’ve been to some remote areas of Lesotho by car before, but never by foot. The experience gave me a renewed appreciation for how beautiful Lesotho is; I will never tire of green mountains, blue skies and big fluffy clouds. Even when the endless mountains means another mountain I’ll have to walk over to get to my destination. More importantly, however, our hike gave me a new appreciation for the challenges Lesotho is facing to reduce maternal mortality
Lesotho has one of the highest maternal mortality ratios in the world at 1,155 deaths per 100,000 live births. In my work we have been thinking and planning over the last almost 18 months for how we can support the Government to reach its goals to reduce maternal mortality to 300 deaths per 100,000 live births. One of the key drivers of maternal mortality is the lack of access to skilled delivery services. Whenever I get the opportunity I will go on at length about how women want to deliver in a facility but that the facility where they attend ANC do not conduct deliveries and the hospital is too far. “We,” I argue, “Need more health centres that conduct deliveries, not just hospitals.”
I still believe that I’m right about that. I believe it even more after the hike. What hiking for three days really drove home for me though was how much I’ve simplified the issue in my head. We passed exactly three health centres – one at the starting point in Malealea and two at the end in Semonkong with nothing in between. As we went through a village with lots of small children calling out to us at the end of day 1 I thought to myself, “Where were these children born?” A woman would have to walk at least 6 hours – or ride a horse – to get to Malealea. Last I heard Malealea Health Center was not conducting deliveries, but even if they were the challenge of getting there would still be tremendous. As policymakers we talk about building “waiting mother shelters” for pregnant women to wait for the onset of delivery at a health centre but what does a woman do with her family while she’s there? Don’t even get me started on the challenges of having skilled health workers at the facility to perform the delivery.
I normally come back from a holiday refreshed and ready to get back to work. After last weekend I came back with a renewed sense of purpose. Excited to think again about what my organization can do to support the Government. It is an experience that will continue to motivate me as we carry our work forward.